Moderator comment on ProMED: Marjorie Pollack
MERS-CoV continues to circulate in Saudi Arabia with the occasional spillover into humans from camel exposure, or close contact with other cases. It clearly is an infection that has transmission enhanced in the healthcare environment when there are breaches in infection-control practices. While Saudi Arabia is clearly the epicenter for human cases, the virus is circulating in the dromedary population elsewhere in the Middle East, North Africa, and Pakistan.
During the month of September 2018, there were 13 newly confirmed cases in Saudi Arabia and 1 newly confirmed case in South Korea, the latter in an individual who had traveled to Saudi Arabia for business, with onset of illness occurring upon return to South Korea. Six of these 14 newly confirmed cases had fatal outcomes. Classifications of type of transmission involved for these 6 fatal cases included 1 with a history of camel exposure, 2 primary community acquired with no history of camel exposure, 2 following further investigation found to be healthcare associated, and 1 remaining unknown.
For those who are interested in drilled-down data on the MERS-CoV epidemiology, I highly recommend going to: http://applications.emro.who.int/docs/EMROPub_2018_EN_20487.pdf where there are graphics and tables with more detailed information supporting the above given numbers.
It is hard to reconcile total number of cases from the variety of reports. The August situation report stated there had been a total of 2248 cases including 798 associated deaths. The current September report total is up to 2260 cases, including 803 associated deaths. Hence, that’s 12 newly confirmed cases and 5 newly reported fatalities.